Healthy Hearts Northwest's primary aim is to compare the effectiveness of adding shared learning opportunities, educational outreach, or both to practice facilitation (PF) for building QI capacity within smaller primary care practices, with a focus on cardiovascular disease risk-factor control. A secondary aim is to assess if PF alone improves clinic-level ABCS outcomes (Aspirin-Blood pressure-Cholesterol-Smoking cessation). Practice facilitation is given to all practices in our randomized trial population.